Rifampin: The Cause of Acute Tubular Injury—A Case Report

Tuberculosis (TB) presents with fever, night sweats, and cough. The antituberculous therapy (ATT) used to treat TB affects various systems, including the renal system and the hepatobiliary system. ATT-induced acute tubular necrosis (ATN) can have various presentations, such as fever, vomiting, diarrhea, abdominal pain, oliguria, and cola-colored urine. We present a case of a 56-year-old patient using ATT. He presented with the complaint of altered mental status, vomiting, jaundice, and cola-colored urine. Labs revealed elevated liver enzymes, elevated creatinine, anemia, and thrombocytopenia. The autoimmune profile was normal; however, the biopsy revealed ATN. In addition to supportive management, hemodialysis and steroid therapy were initiated. Discontinuation of rifampin along with continuation of modified ATT therapy led to improved renal function tests, platelet counts, and Hb levels.